Multicenter clinical trials. Potential influence of consumer education

Multicenter therapeutic trials have demonstrated clearly the efficacy and safety of antihypertensive therapy. Such studies were designed initially to demonstrate the effectiveness of antihypertensive therapy in preventing complications and fatalities from hypertensive disease. Over the three decades since these studies were instituted, succeeding trials have become more sophisticated in design, and those of us who observe and interpret their results have similarly become more sophisticated and more demanding. However, we should not expect more from the studies than their designers intended. Let us neither overinterpret the results nor ascribe failure to studies simply because they do not answer the questions that remain. This discussion concerns primarily three recent multicenter clinical trials: the Hypertension Detection and Follow-up Program (1979), the Australian National Blood Pressure Study (1980), and the Multiple Risk Factor Intervention Trial (1982).